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The number of young people admitted to general hospital wards in England with a mental health concern jumped 65 per cent in the 10 years to 2022, according to research that suggests thousands of children may not be receiving the specialist care they need.
The surge in admissions of those aged five to 18 for mental health — from 24,198 to 39,925 — compared with a 10 per cent increase in “all cause” admissions between 2012 and 2022, according to the study published on Wednesday.
Around the world, most countries have been grappling with big rises in demand for mental healthcare, an issue thrown into sharp relief by the coronavirus pandemic. The substantial increase in patients in England comes as the NHS is struggling to meet record demand across its services.
The researchers at University College London said their findings “provide important messages for health policy internationally on delivering care for children and young people admitted in acute settings due to mental health concerns”.
Increases in mental health admissions in England were biggest among girls between the ages of 11 and 15, rising from 9,091 to 19,349, or by about 113 per cent, said the study, the first to analyse national trends in acute medical wards.
A surge of almost 515 per cent in admissions related to eating disorders was one of the biggest drivers behind the overall increase, according to the paper in The Lancet Child and Adolescent Health journal.
The researchers also identified steep rises in the admission of children between the ages of five and 10, “with striking rates of self-harm in females” in this group, although absolute numbers were still low.
Lee Hudson, senior author of the study and clinical associate professor at UCL Great Ormond Street Institute of Child Health, said acute medical wards were important places for caring for young people with mental health concerns, especially those who also had physical health problems such as starvation from an eating disorder.
“However, the increased intensity we describe is presenting real challenges for acute wards, both for patients and their families and the staff supporting them,” he said.
The researchers cited recent findings from the Health Services Safety Investigations Body, an arms-length body, that in 13 of 18 paediatric units surveyed, the ward environment was “not safe” for caring for children and young people with “high-risk behaviours related to mental health concerns”.
The researchers suggested that while Covid-19 had contributed to deteriorating mental health among young people, annual increases were registered across the entire 10-year period they had studied.
Further work was needed “to examine how trends have evolved as the pandemic has subsided, although early data suggest there has not been a reduction to pre-pandemic levels”, they added.
In an attempt to protect mental health expenditure, all of NHS England’s integrated care boards, which manage budgets in different parts of the country, are at present required to ensure investment in mental health rises at a faster rate than their overall budget.
But Hudson called for “better co-working between physical and mental health professionals across hospital and community teams, including, for example, adequate provision of psychiatrists and mental health trained nurses to support physical medical care on the actual ward”.
Researchers did not reach a firm conclusion as to whether difficulty in accessing support at an earlier stage in the community, before mental health problems escalated, was partly to blame for the soaring admissions.
But “a population-level increase in mental health conditions” had emerged clearly from the data, Hudson added.
Claire Murdoch, NHS England’s national mental health director, said treatment and awareness of such conditions had vastly improved over the past decade, “but that also means the health service is treating record numbers as well as dealing with new issues like the negative impact and pressures that social media has on body image”.
The NHS had rolled out hundreds of mental health teams in schools and set up 24/7 crisis support “but sometimes an admission to hospital is in the person’s best interest” to reduce the risk of harm, she said. Despite the rise in demand for services dealing with eating disorders, more than four-fifths of children started urgent treatment within a week, Murdoch added.
